Phillip Titterington, executive director, Medina County ADAMH Board and co-chair of the Medina County Opiate Task Force (left) and Fr. Bob Stec, pastor of St. Ambrose Church, were part of a June 21 panel in Brunswick discussing a growing opioid epidemic in the community.

BRUNSWICK --- However inadvertently, Fr. Bob Stec's anecdotal recollection of a recent meeting of the grassroots Greater Than Heroin group illustrated not only the need, but the urgency of the city's most recent gathering of community members, medical professionals, clergy and law enforcement officials taking a closer look at what has become a crisis of epidemic proportions.

At a June 21 panel at Brunswick City Hall, entitled "Heroin, Fentanyl and Carfentanil: The Triple Threat on Our Doorstep," and organized by the Cleveland Clinic, the St. Ambrose Church pastor recounted how three construction workers at the church during the Greater Than Heroin meeting took the group up on its offer of food, not knowing what the topic of the gathering even was.

As it turned out, Stec said, each had a loved one or friend of the family who was addicted to, or had died as a result of heroin. Moreover, though they were co-workers, none of the men was aware of the others' story.

Community engagement

The June 21 gathering was part of a series of panel discussions to bring residents, community partners and local experts together to engage in open conversation about the opioid epidemic and empower community members by connecting them to the resources and information they need to combat the opioid crisis.

The panel pulled few punches when discussing the reality of opioid addiction, laying out disturbing facts such as a rise in opioid-related overdose deaths in Northeast Ohio from 92 in 2014 to 138 in 2016.

"And we are at 117 so far in 2017," Pinjuh said. "We are fighting a battle of epic proportions."

The comprehensive conversation touched on topics such as the panelists' recommendations for families and friends when loved ones refuse treatment; the role of the ADAM board and Opiate Task Force in making treatment process of accessing treatment easier; the fear of the effects of withdrawal, which one recovering addicted quoted in the presentation likened to being held underwater "and for only $30 you can feel O.K."; how reporting drug activity can reduce demand, something even infamous Mexican drug cartel leader Joaquin Archivaldo Guzman "El Chapo" Loera has been quoted as saying would severely reduce and possibly even end epidemic levels of drug abuse and its resulting criminal activity; concerns with possible changes to insurance plans and Medicare, and how prepared charitable and other local community agencies are to stand in the gap, with 700,000 Ohioans who are currently covered by Medicare under the Affordable Care Act receiving treatment for drug addiction and mental illness; "invisible victims" of the opioid crisis - 14,000 children in 2016 in agency custody, often due to a drug addicted parent or caregiver; and the usefulness of - and controversy surrounding - medication assisted addiction treatment such as Buprenorphine and Methadone.

In fact, DiFrangia said, simply getting to treatment centers and accessing these medications is often a major stumbling block for many addicts, from both a practical and financial standpoint.

Where it began, where it is going

DiFrangia outlined a number of frightening statistics, both nationally and in Ohio, including the fact that the United States, with has less than 5 percent of the world's population, consumes 80 percent of the world's opioids and 99 percent of its hydrocodone - Vicodin and Norco.

And while Ohio has one of the most aggressive and comprehensive approaches in the nation to fighting the opioid epidemic, spending $1 billion annually on prevention, treatment, and law enforcement, the state also leads the nation in deaths from opioid overdoses - 4,000 lives lost to overdoses in 2016 alone.

That death rate, Pinjuh said, is largely blamed on the easy availability of Fentanyl and Carfentanil.

Fentanyl was first produced in 1960 and is considered to be 40-50 times more potent than pure heroin. Often mixed with heroin, "China White" is also distributed in injectable liquids, patches, lozenges and pills, Pinjuh said.

In fact, a salt grain-sized amount of Carfentanil, if touched or inhaled, could kill "every one of us up here," he said.

Produced primarily in Mexico and China and shipped to the U.S., from 2011 to 2015, there was a 525 percent increase in Fentanyl overdoses in Cuyahoga County and Fentanyl seizures increase by nearly 2 percent in Northeast Ohio between 2014 and 2016.

Simple answer, difficult job

Pinjuh also cautioned people to be aware of the "drug dealer in your home; the medicine cabinet." In 2015, 52,404 Americans died of a drug overdose, up from 37,004 in 2009. Prescription drugs were the leading cause until 2012, when they were surpassed by heroin.

In 2014, The National Survey On Drug Use And Health showed that 4.5 million Americans used prescription drugs recreationally. Meanwhile, nearly half a million emergency room visits in 2009 were due to people misusing or abusing prescription painkillers.

Research has also shown that four out of five heroin and Fentanyl users started with prescription opioids.

Yet, as daunting as the task seems to be, the answer is likely a simple one; and much easier said than done.

"Heroin is a different beast, but this does lead to a deeper reflection of why people are in such personal pain," Stec said. "In times gone by, we did have a higher threshold for pain; we've been conditioned to feel that all pain is bad - emotional, physical and spiritual pain."

Indeed, Titterington, said a recent visit to the emergency room with his 11-year-old son, who had been injured during a recreational league baseball game, drove this point home to him when the family was offered a choice of Tylenol or Oxycodone for pain.

"We said we would stick with the ice and the Tylenol," Titterington said, adding that "we can't let our guard down."

"Even with your doctors, if you feel uncomfortable, speak up," he said.

Stec echoed that sentiment.

"Until we have the collective will to face this, law enforcement can't work this out alone," he said.

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